Catecholamines, Fractionated, 24-Hour Urine with Creatinine (39627X)

Test Code

TUCAT

Quest Code

4168N

Alias/See Also

4168N, 39627X

CPT Codes
82384, 82570

Includes

Epinephrine, Norepinephrine, Calculated Total (E+NE), Dopamine, and Creatinine

CPT code 81050 may be added at an additional charge for volume measurement

Preferred Specimen

1 mL preserved 24-hour urine with 25 mL 6N HCl collected in a plastic 24-hour urine container

Patient Preparation
It is preferable for the patient to be off medications for three days prior to collection. However, common antihypertensives (diuretics, ACE Inhibitors, calcium channel blockers, alpha and beta blockers) cause minimal or no interference.
Patient should avoid alcohol, coffee, tea, tobacco and strenuous exercise prior to collection.

Minimum Volume

0.7 mL

Other Acceptable Specimens

Unpreserved 24-hour urine with a pH ≤6

Instructions

Collect 24-hour urine with 25 mL of 6N HCl to maintain a pH below 3. Urine without preservative is acceptable if pH is below 6 and the sample is shipped frozen. Record 24-hour urine volume on test request form and urine vial.
Submission with no preservative and pH adjustment is acceptable as long as shipped frozen, per QNI CS.

Transport Temperature

Room Temperature

Specimen Stability

Preserved urine
Room temperature: Unacceptable
Refrigerated: 30 days
Frozen: 60 days

Unpreserved urine
Room temperature: Unacceptable
Refrigerated: 7 days
Frozen: 60 days

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)

Preserved urine received refrigerated with pH >3 • Unpreserved urine received frozen with pH >6

Methodology
Liquid Chromatography/Mass Spectrometry (LC/MS)

FDA Status
This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by FDA. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.

Setup Schedule

Set up: Mon-Sat; Report available: 3-4 days

Limitations

Recent surgery, traumatic injury, upright posture, cold, anxiety, pain, clonidine withdrawal, and concurrent acute or chronic illness may produce elevated results..

Reference Range

See Laboratory Report

Clinical Significance

The three catecholamines (norepinephrine, epinephrine and dopamine) are the principal secretory products of neural tissue. Clinically, the measurement of circulating catecholamines is valuable in the diagnosis of catecholamine secreting tumors associated chiefly with hypertension (pheochromocytomas, neuroblastomas and gangliomas) and with the evaluation of orthostatic hypotension.

Performing Laboratory
Quest Diagnostics Nichols Institute
33608 Ortega Highway
San Juan Capistrano, CA 92690-6130

The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.